Medway House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means

we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff understood the importance of recording any accidents, incidents or near misses. These were reviewed by the management team, and steps were taken to help prevent similar events reoccurring. This included making referrals to health professionals and discussions with people and their families to help promote people’s safety.

People using the service and their relatives understood how to raise concerns. They said the registered manager was approachable, and they would not hesitate to speak with them should they have any concerns.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had an admissions policy in place which they adhered to. Prior to admission, people and their families were involved in the pre-assessment process, where the registered manager gathered information to make the transition an easier experience.

The team worked with healthcare professionals, including GPs and specialist practitioners, to monitor people’s health conditions and respond promptly to any changes in their support needs.

Effective systems were in place to share information with other services. People’s care and health records were kept up to date. Staff told us there was good communication at the service which ensured they knew about changes in people’s care and treatment. Essential information about people was readily available should they need to be admitted to hospital.

The provider did not always ensure people were safeguarded from abuse, avoidable harm or restrictions that were not in line with best practice. Improvements were needed to ensure people's rights were consistently protected and promoted.

The provider had implemented blanket restrictions which limited people's independence and freedom within their home. People were unable to independently access the fridge and freezer to obtain food and drinks. The provider had not demonstrated these restrictions were individually assessed, proportionate, or the least restrictive option available. This meant people were not always supported in a way that promoted their human rights, choice and independence.

The provider's systems had identified these restrictions, but the provider had not addressed this long-standing practice. As a result, some people were exposed to unnecessary restrictions which could negatively impact their autonomy and right to live as independently as possible.

Notwithstanding the above, the provider reported safeguarding concerns and worked with the local safeguarding authority to investigate these and keep people safe from avoidable harm.

Staff understood their responsibilities to protect people from harm and were able to describe how they would recognise and report safeguarding concerns. Staff told us they would report concerns to managers and escalate concerns externally if required.

People using the service and their relatives told us they thought people were safeguarded from abuse.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments and care plans reflected people's individual circumstances and staff updated these when needs changed. We saw examples of people being supported by staff to maintain relationships, go out and about and make choices about their care whilst risks were managed safely together. The provider worked with healthcare professionals and others involved in people's care to help ensure people could do the things that mattered to them in the safest way possible.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People lived in an environment that was appropriate for people’s needs and checked for its safety.

The registered manager undertook regular checks of the environment. We saw there were systems in place to ensure the environment and equipment were safe, such as fire safety equipment checks, electrical equipment checks, food safety and environmental checks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited through robust processes, which included providing references, a full work history, their fitness for the role and their right to work in the UK. We reviewed a sample of recruitment records, and they confirmed information had been received to satisfy the provider that staff had the necessary skills and experience to support people. 

Systems were in place to ensure staff were suitably trained and skilled for roles. Staff had access to a range trainings, refresher training was scheduled to ensure staff remained suitably skilled. Staff were provided with regular supervision and annual appraisals to support staff performance and professional development. 

The provider had effective systems in place to monitor training to ensure that staff remained suitably skilled and trained for their roles.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We reviewed infection prevention and control audits and action plans, which showed leaders-maintained oversight of environmental cleanliness and cleaning arrangements.

Records demonstrated leaders routinely monitored cleaning schedules helping to ensure infection prevention and control arrangements remained effective.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely and as prescribed. Staff supported people to access healthcare professionals who reviewed their medicines.

Trained staff administered medicines in line with the provider’s medicines policy. Staff had completed competency assessments and received regular refresher training. 

There were clear and accurate records relating to medicines, including when these were administered. Medicines were stored appropriately.

The registered manager conducted regular medicines audits to reduce the likelihood of errors. Staff monitored stock and recorded medicines use accurately on medicines administration record charts.